My classmates and professors tell me I overthink it. “You overanalyzed the problem.” “Stop mulling it over.” “Just focus on the buzzwords and you’ll rock the exam.” “Jump through the hoops and move on.”
But I cannot. I refuse to give into the bureaucracy! The qualities of my character — namely an unrelenting stubbornness — drive me to full-on dissidence against the cliché “don’t overthink it.” The phrase makes my skin crawl. It insults my intelligence by undermining the very passions that drew me to medicine in the first place.
I did not pursue this long and arduous path because I desired wealth or admiration. Nor did I choose to achieve a career that was predictable or simple. I sought the challenge of the unknown, to battle against time and death to solve the mysteries of the human condition. To provide hope and maybe a few second chances to those in pain and desperation. I wanted a career where at the end of the day, no matter what the outcome, I knew I gave my all to those I was responsible for.
After almost two years in medical school I have become eerily aware that we are being prepared for “conveyor belt medicine.” A fictional world where patients present with well-explained, easily treatable problems that require nothing more than an algorithm and a 25 percent probability of guessing the right answer. A place where zebras are more commonplace than cats and every patient is compliant and trustworthy.
Just imagine it, Mr. Smith strolls into your office and gives you a 10 second synopsis of his symptoms — revealing a few juicy buzzwords in the process. Then he removes his gown and you follow the instructions pinned to his chest:
For strep throat, circle the mouth. For coronary artery disease, circle the left nipple. For gastroenteritis, circle the navel. And for sexually transmitted infections…you get the idea.
You mark your answer, then send the patient on their way down the conveyor belt. In their hand, a prescription, a satisfaction survey and a cherry lollipop to seal the deal. All in a day’s work — nailed it!
The truth is real life patients rarely present the way they do on multiple-choice exams. The answers to their problems are seldom solved by one or two novel treatments. They have genetic, social, religious and even spiritual facets that contribute to the complexity of their condition. Many times, the unknown persists and as their providers we will be forced to accept this. However, appreciating that some problems cannot be solved is not an excuse for complacency. We are called to exhaust our minds and to employ our passion for the benefit of our patients.
Sir Arthur Conan Doyle was a writer and a physician in the late 1800s. His character Sherlock Holmes has become a staple in my digestion of literature over the years. Holmes solved every crime with such eccentric enthusiasm, devoting the depths of his brilliance to each case and was astutely observant to every detail. In the mind of this genius, nothing occurred by happenstance. Everything had a purpose and a contribution. His neurotic passion was infectious. I thought to myself, “If I could contain even a fraction of this character’s brilliance, oh the mysteries I would solve!”
It was not until recently I learned that the character Sherlock Holmes was actually inspired by a physician, Joseph Bell. Rumor states that he was very much like the man in those famed stories. However instead of solving crime, he solved disease. I like to imagine that he did so with every bit of passion and tenacity as the character he inspired. He was an overthinker. A true physician.
The next time a professor tells you that you’re overthinking it, just bite your tongue and jump through their hoop. But agree to disagree and never stop overthinking it. You may not receive admiration from the academic world and you may not receive the high score on the test. But be true to yourself and your patients will benefit from that commitment. That, my friends, is what matters most.